Provider Demographics
NPI:1063482206
Name:MANNS-JAMES, LAURA E (CNM)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:MANNS-JAMES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 364
Mailing Address - Street 2:247 WHITE ST
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962
Mailing Address - Country:US
Mailing Address - Phone:606-599-8297
Mailing Address - Fax:606-599-8568
Practice Address - Street 1:247 WHITE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962
Practice Address - Country:US
Practice Address - Phone:606-599-8297
Practice Address - Fax:606-599-8568
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4300M367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78011590Medicaid
KY78011590Medicaid